An Incredible Opportunity To Learn From Professor Alain Carpentier, The “Father” Of Modern Heart Valve Surgery
I’m a history buff. That said, I was beyond excited to meet Professor Alain Carpentier at the Mitral Conclave. If you did not know, Professor Carpentier is widely regarded as the “Father” of modern heart valve surgery.
Adam, Professor Alain Carpentier, Dr. David Adams & Dr. Friedrich Mohr
After the introduction, I was fortunate to witness the filming of a very, very, very special interview with Professor Carpentier. Thanks to Dr. David Adams and Dr. Randy Martin, I am able to share portions of that interview below.
I encourage all patients and caregivers to watch this video and learn about this incredible man. As you will hear, Professor Carpentier’s curiosity triggered many of the innovations that transformed valvular treatment.
For those members of our community who are hearing impaired, I have provided a written transcript of Professor Alain Carpentier’s video interview below.
Dr. Randy Martin: Well, I’m obviously privileged, like all of us, to have a chance to visit with Professor Carpentier. Professor, you sat in the audience this morning. I saw you in the audience this morning. Sitting on the podium, I was overwhelmed at 900 individuals here to learn about mitral valve regurgitation disease and the operative repair. What’s it feel like for you to see, you know, what you’ve postulated all these years and taught us all to have this much of a gathering?
Professor Alain Carpentier: Well, I couldn’t imagine it, you know, the how vast and how deep would be the changes in the mentality of the surgeon with regards to valve disease. I think has something to do with a current evolution of the society…
Dr. Randy Martin: Um, hum.
Professor Alain Carpentier: And, mainly then the fact that our society, the people are mainly concerned by quality of life. I have only one definition to make comparing the surgery from the past to the surgery of today or tomorrow, I would only say “quality of life”. And, in the past the people were afraid to have a real operation. That’s why they didn’t like valve repair or bioprosthetic valve replacement. Today they say, “Well, give me a normal life for 10, 15, 20 years so that I can enjoy life,” and this is, of course, the unexpected success of what I call non-thrombogenic surgery.
Dr. Randy Martin: So you’ve been a proponent of not only excellence in cardiac surgery, but this concept of really understanding the mitral valve and repair. To see where it is, too see, I mean, just sitting in the room and seeing 900 people sitting there spending a morning and two days talking about this, it must be very encouraging to you, isn’t it, to see, you know, how it’s come to that? (Click here to learn about mitral valve repair procedures.)
Professor Alain Carpentier: Well, I’ve been encouraged in the past, also, and I would say it was mainly a surprise. It is, of course, encouraging, as you said. It is a surprise but this is the merit of David Adams who was able to – He is really, in this country, the promoter of these techniques. There are very few people having caught the spirit of valve reconstruction because this is really the term ‘spirit’ that’s probably the best to spread that and I go back to the beginning by saying that how important is the quality of life.
Dr. Randy Martin: The concept in your paper in 1983, you know, most cardiologists, and I’m obviously a cardiologist, most cardiologists didn’t had no concept, and I’m afraid even today many of them, the concept of the incredible structure of the mitral apparatus and how you would repair it so, you know, you’ve not only enlightened surgeons but you’ve also enlightened cardiologists in that.
Professor Alain Carpentier: In relate to, I like to work with cardiologists from the very beginning. You know, they – There is a tendency for surgeons to think that they know everything and that the cardiologists don’t know anything. I have a totally different approach and I’ve been introducing the cardiologists in the operating room, probably the very first in the world, from the very beginning. This was at the beginning of the availability of echocardiography.
Dr. Randy Martin: Right.
Professor Alain Carpentier: And working as a team is such a gratifying approach and allows you to really improve your techniques and improve your result because the cardiologist is in the operating room. He tells you there is a heart valve leak. Nah, there is no leak. Yes, there is a leak. You have to go back.
Dr. Randy Martin: Where do you think mitral valve surgery is going in the future if you had to look down the way or mitral valve disease repair, where is that going in the future?
Professor Alain Carpentier: One has to realize that today 50% of the mitral valve diseases are not admitted to surgery.
Dr. Randy Martin: Right.
Professor Alain Carpentier: And these 40%, or 35% exactly, will be operated on in the future. That’s number one. And number two, since the population is getting older…
Dr. Randy Martin. Right.
Professor Alain Carpentier: We’ll see, you know, a greater number of people affected by degenerative valvular disease, whatever is the type of degenerative valvular disease, so mitral valve reconstruction is going to evolve. My concern, and I do have a concern. My concern is that it is a the surgery which requires some effort on the part of the surgeon and it’s difficult, more difficult than a heart valve replacement, so I’ve been pleased to see the move towards valve repair although valve repair is more difficult is the one, you know, I think that’s a reward. That is a reward. And it’s due to people like Dr. David Adams.
Dr. Randy Martin: Well, I think, I mean you’re exactly right and, again, it goes back to your quality issue. In other words, if we know, and you’ve helped educate us, that if you do an excellent repair that the quality, the affect on the left ventricle, the affect on the right ventricle, the affect on the atrium, the quality of life and the affect on the patient improves. Tell me a little bit about the – your passion with the non-thrombogenic valve for which you won the Lasker Award. Tell me a little bit about that.
Professor Alain Carpentier: Well, the concept came from the patient rather than from me. That is to say, the patient’s request. Of course, although valve repair has been associated with tremendous progress, still there are cases which require a valve replacement. Valve replacement is an easier operation but it has adverse effects when using mechanical heart valve replacements.
Dr. Randy Martin: True.
Professor Alain Carpentier: There have been these problem, at the very beginning of cardiac surgery or valvular surgery. So I told myself, you know, that repair, if we can improve it, we’ll improve it but what about a valve replacement if necessary. And then I began to analyze what could be done and, of course, I went back to the laboratory and then, as you know, made some chemistry to improve the durability, to introduce first, and then to improve the durability of animal valves.
Dr. Randy Martin: It’s interesting because I began medical school in 1965 so it’s really at the earliest stages of valve…
Professor Alain Carpentier: Absolutely.
Dr. Randy Martin: Did you meet resistance from your colleagues as the mechanical valves were coming along and you certainly were going a different route. People would say not only they just not going to last. Did you meet resistance from your colleagues over that?
Professor Alain Carpentier: Well.
Dr. Randy Martin: They’re not going to last. They’re going to fall apart.
Professor Alain Carpentier: To say the least. To say the least. Because it was a crazy idea.
Dr. Randy Martin: Oh, absolutely.
Professor Alain Carpentier: Using an animal valve…
Dr. Randy Martin: Absolutely.
Professor Alain Carpentier: To replace a human valve was a crazy idea and the reason I persisted is due to the fact that the crazy idea was non-thrombogenic and the only downside was the only limitation was immunological reaction. Let’s say, say we had acute rejection…
Dr. Randy Martin: Um, hum.
Professor Alain Carpentier: In animal…
Dr. Randy Martin: Um hum.
Professor Alain Carpentier: Before trying to a human. So I told myself, there are two ways using – I want to use these animal valves because they are available with no risk of infection or whatever. That’s why I stick to the animal valve and also because they’re – it was a larger availability in different sizes. However, there were these problem of immunological reaction and then I started by trying to think about it and again, because of the quality of life issue, I told myself instead of treating the patient to reduce immunological reaction, I’m going to treat the tissue and that’s probably the most interesting, intellectually interesting, invention that I’ve ever done.
Dr. Randy Martin: It’s, you know, it sounds simple but it’s a very unique concept.
Professor Alain Carpentier: It, yeah, it was…
Dr. Randy Martin: As you look to the future again in valves in general, where are we going?
Professor Alain Carpentier: I don’t know. We are looking for different material. Have been, you know, hundreds of different materials used and tried hoping that they will mimic, you know, the natural tissue but up to now, not been any but, you know, we should never say “never”. It will come. For the moment as far as I’m concerned, I’m following the way I have always, you know, followed. That is to say trying to improve the durability by improving the method of preservation and I mean we have made significant…
Dr. Randy Martin: Yeah.
Professor Alain Carpentier: Progress. I mean many people think by studying valve for the last seven years or eight years like they did when you were in Stanford. However today we see patient, you know, reaching 15, even 20. I now have several patients reaching 25. But that doesn’t mean that it is a rule. The rule is depends, as you know, on the patient.
Dr. Randy Martin: If you were talking to young surgeons or a young cardiologist about the practice of their profession, what would you tell them?
Professor Alain Carpentier: Be good.
Dr. Randy Martin: Be good.
Professor Alain Carpentier: In order to be good, work and work and work. But that’s not enough. I would say you must be very curious. I mean an innovator is characterized by his curiosity. Curiosity, for me, means you have to look around and try to catch and understand all the pending problems and there are still many pending problems to , many, many pending problems. So, in other words, I see the future of valve surgery or valve surgery, valve pathology or valve treatment. For example, I’m sure in the 10 or 15 or 20 years, there will be some techniques, gene technique or cell therapy, which can be – which will be delivered through the locally. I don’t know. It’s always good to dream.
Dr. Randy Martin: Well, I want to – You’ve got to go down and give a fascinating lecture but I want to thank you because you’ve had two of the three tenets that I think are important in life. You’ve had a passion for excellence. You’ve had the concept of being able to give to others and you think about that and also the third tenet which is that people in relationships are very important. You’ve trained. You’ve been generous. You’ve trained others and, you know, we’re all – The world’s a better place because you’ve been curios and you’ve worked at being good, so thank you very much.
Professor Alain Carpentier: Thank you for these kind remarks.
For those members of our community that are hearing impaired, I have provided a transcript of Professor Carpentier’s video below.
Keep on tickin’ Professor Carpentier!!!
Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.